All-on-4 dental implants: what to expect, step by step

What is All-on-4?

All-on-4 is a way of replacing a full arch of teeth — all the top teeth, all the bottom teeth, or both — with a fixed bridge that's held in place by just four dental implants. Instead of placing one implant for every missing tooth, the four implants are positioned so they can carry a complete set of teeth between them.

The name refers to the technique: two implants go in near the front of the jaw, and two go further back at an angle. Angling the back implants lets them use more of the bone you already have, which often means you can avoid a bone graft. You'll also see it written as "All on 4", and when a jaw needs five or six implants instead, it's sometimes called All-on-X. They're all types of full-arch implant treatment.

Who is All-on-4 for?

All-on-4 is usually considered when someone:

• is missing most or all of the teeth in their upper or lower jaw
• has several failing teeth — from decay, gum disease or old dental work — that make more sense to replace together than one at a time
• wears a full or partial denture that's loose, uncomfortable or makes eating difficult
• has been told they don't have enough bone for traditional implants

You'll need to be in reasonable general health. Smoking, uncontrolled diabetes and some medications can slow healing and affect how well implants bond with the bone, so we'll go through your medical history carefully. None of these automatically rule you out, but they do change the plan.

If you're only missing one or two teeth, a single tooth implant or a bridge is usually the better option.

The All-on-4 process, step by step

1. Consultation and scans

Everything starts with a proper assessment. We'll examine your mouth, take X-rays and 3D scans to measure the height and density of your jawbone, and talk about what you want from treatment. This is where we work out whether All-on-4 suits you, how many implants you need, and whether any teeth need to come out first. You'll leave with a written plan and an itemised quote.

2. Planning your new smile

Your implants are planned digitally, so their position and angle are mapped out before surgery. We'll also plan the shape, size and shade of your new teeth, so they suit your face rather than looking like a generic "denture smile".

3. Surgery day

Any remaining teeth that can't be saved are removed, and the four implants are placed in the same appointment. It's done under local anaesthetic, and if you're anxious, IV sedation or general anaesthesia can be arranged so you're relaxed or asleep throughout.

4. Same-day temporary teeth

For most eligible patients, a temporary fixed bridge is attached to the implants on the day of surgery or very soon after. That means you don't go home without teeth. The temporary bridge is lighter than the final one and lets the implants settle in without too much force on them.

5. Healing

Over the next three to six months, the implants fuse with your jawbone — a process called osseointegration. During this time you'll stick to softer foods and come in for a few short reviews so we can check everything is healing as it should.

6. Your final bridge

Once the implants are fully integrated, we take new impressions and fit your permanent bridge. It's stronger and more refined than the temporary one, and it's designed to last for many years with good care.

What recovery is really like

Most people are surprised that the discomfort is less than they expected. Swelling and tenderness usually peak around day two or three and settle within a week, and over-the-counter pain relief is enough for most patients. Plan to take a few days off work, and if you're having sedation you'll need someone to drive you home.

For the first few months, you'll eat soft foods — think eggs, fish, pasta, well-cooked vegetables — and avoid anything hard, sticky or very chewy while the implants heal. After your final bridge is fitted, you can eat almost everything you'd eat with natural teeth.

All-on-4 vs dentures

The biggest difference is that All-on-4 teeth are fixed. You don't take them out at night, there's no adhesive, and they don't move when you eat or talk. Because the implants are anchored in bone, you can bite with far more force than you can with a denture, so foods like steak, apples and crusty bread are back on the menu.

There's a long-term benefit too. When teeth are lost, the jawbone gradually shrinks because nothing is stimulating it. Dentures sit on top of the gums and don't stop that process, which is why they tend to get looser over the years. Implants act like tooth roots and help preserve the bone, which also helps keep the natural shape of your face.

How much does All-on-4 cost?

The cost of All-on-4 varies from person to person, so we don't quote a one-size-fits-all price. The main things that affect it are:

• whether you're treating one arch or both
• how many implants you need — four, or more for All-on-X
• whether extractions or a bone graft are needed first
• the material of your final bridge
• whether you choose IV sedation or general anaesthesia

After your consultation and scans, you'll get a clear, itemised quote so there are no surprises. Many health funds with extras cover pay something towards implant treatment, so it's worth checking your policy. We can claim on the spot with HICAPS, and interest-free payment plans are available.

Looking after your All-on-4 teeth

Your new teeth can't get decay, but the gums and implants underneath still need care. Brush twice a day, clean under the bridge with a water flosser or interdental brushes, and keep up regular check-ups and professional cleans. From time to time we may remove the bridge to clean it thoroughly and check the implants. Look after them, and your implants can last for decades.

Book an All-on-4 consultation in Underwood

The best way to find out if All-on-4 is right for you is a consultation. Dentist at Underwood is on Logan Road in Underwood, close to Springwood, Rochedale, Slacks Creek and Eight Mile Plains, and we're open 7 days — so you can come in on a weekend if weekdays don't work.